Text for the CHF Brochure

(the first part of this file is the text designed to support the medical
art in the first two columns of the brochure's "outside")

What
is Congestive Heart Failure?

Congestive heart failure
(CHF) occurs when the heart loses its ability to pump enough blood through
the body. Usually, the loss in pumping action is a symptom of an underlying
heart problem, such as coronary artery disease.

The term heart failure suggests a sudden and complete stop of heart activity.
But, actually, the heart does not suddenly stop. Rather, heart failure
usually develops slowly, often over years, as the heart gradually loses
its pumping ability and works less efficiently.

[drawing
of vascular system

in
the first column]

Some people may not
become aware of their condition until years after their heart began its
decline.

What
are the Symptoms?

Perhaps the best known
symptom is shortness of breath ("dyspnea"). In heart failure, this may
result from excess fluid in the lungs. The breathing difficulties may
occur at rest or during exercise. In some cases, congestion may be severe
enough to prevent or interrupt sleep.

Being tired is another
common symptom. As the heart's pumping capacity decreases, muscles and
other tissues receive less oxygen and nutrition. Without proper "fuel,"
the body cannot perform as much work, and is tired.

Fluid accumulation,
or edema, may cause swelling of the feet, ankles, legs, and occasionally,
the abdomen. Excess fluid retained by the body may result in weight gain,
which sometimes occurs fairly quickly.

Types
of CHF:

Diastolic heart
failure--This occurs when the heart has a problem relaxing. The heart
cannot properly fill with blood because the muscle has become stiff, losing
its ability to relax.

Systolic heart
failure--This occurs when the heart's ability to contract decreases.
The heart cannot pump with enough force to push a sufficient amount of
blood into the circulation.

Is
there a Cure?

There's no cure, but
treatment can be quite successful. Patients can minimize the effects of
heart failure through lifestyle changes and drug therapy.

[drawing
of two hearts, depicting

relaxation
and contraction, at the

bottom
of the second column]

(the following is the text provided to help you with the brochure's "inside")

Stop
Smoking:

Already having been
diagnosed with CHF is no reason to not quit smoking.

There is simply no
safe way to smoke. Although low-tar and low-nicotine cigarettes may reduce
the lung cancer risk somewhat, they do not lessen the risks of heart diseases
or other smoking related diseases. The only safe and healthful course
is not to smoke at all. There is nothing easy about giving up cigarettes.

If you can't quit
the first time, keep trying. Most smokers "slip" three to five times before
they quit for good. But as hard as quitting may be, the results are well
worth it. In the first year after stopping smoking, the risk of coronary
heart problems drops sharply. It then gradually returns to "normal"--that
is, the same risk as someone who never smoked. You have been diagnosed
with CHF, and quitting smoking won't cure it, but no matter what your
age or health, quitting will lessen your chances of additional health
problems.

If you're living with
someone who smokes, realize that the reported dangers of second-hand smoke
are real. Their smoking can kill you. As a CHF survivor, this risk needs
to be taken seriously....

Eat
Healthy Foods:

Proper eating really
can make a difference. Among the lifestyle steps that help you live better
with CHF are: losing excess weight, choosing foods low in salt and sodium,
monitoring cholesterol, and avoiding alcohol.

The more overweight
you are, the harder your heart has to work. Since your body is retaining
excess fluid, some weight is a symptom of the disease, but you probably
know if you're still overweight. Shift to healthy foods to slowly drop
excess pounds, and make life easier for your heart.

Salt and sodium, the
main ingredient in salt, must be watched carefully. Sodium causes your
body to retain fluids, making the symptoms of CHF worse. Be particularly
aware of the salt in canned foods and fast food - two groups whose convenience
is often tempting to those worn down by CHF.

Give up alcohol. Your
heart is weak, and drinking simply isn't worth the extra stress it puts
on your system.

Reduce your cholesterol
and fat intake. Work to eat healthy foods, prepared in healthy manners.
Learn to love salads, and say good-bye to french fries.

Stay
Active:

Although your heart
is damaged, and you may seem tired all too often, the best cure isn't
to sit around, avoiding activity. Rather, work with your doctor and cardio-pulmonary
rehab team to create a program that will allow you to stay active.

As a CHF patient,
you may find that sometimes even the simplest tasks are exhausting. The
concept of an activity schedule may seem laughable. But smart CHFers learn
how to ration their strength, so that they can continue to enjoy the pleasures
of life.

Follow your doctor's
advice, start slow, and look for opportunities to become more physically
active throughout your day:

Use the stairs--up
and down--instead of the elevator. Practice with a few steps and gradually
build up to more.

Park away from the
office or store and walk the rest of the way. Or if you ride on public
transportation, get off a stop or two early and walk a few blocks.

Consider joining
an organized cardio-pulmonary rehab program.

Together, you, your
doctor and your rehab team can create a program to speed up your recovery.

Take
Your Medications:

Several types of drugs
have proven useful in the treatment of heart failure:

Diuretics help reduce the
amount of fluid in the body and are useful for patients with fluid retention
and hypertension.

Digitalis increases the
force of the heart's contractions, helping to improve circulation.

Results of recent studies
have placed more emphasis on the use of drugs known as angiotensin converting
enzyme (ACE) inhibitors. Several large studies have indicated that ACE
inhibitors improve survival among heart failure patients and may slow,
or perhaps even prevent, the loss of heart pumping activity.

Originally developed
as a treatment for hypertension, ACE inhibitors help heart failure patients
by, among other things, decreasing the pressure inside blood vessels.
As a result, the heart does not have to work as hard to pump blood through
the vessels.

Patients who cannot
take ACE inhibitors may get a nitrate and/or a drug called hydralazine,
each of which helps relax tension in blood vessels to improve blood flow.

Ask your doctor about
your medications, what each does, and whether there are any side effects.
Knowing more will help you stick to the schedule that has been prescribed
for you.